Clinical Application of Spectral Envelope Perception: Cochlear Implant Evaluation

频谱包络感知的临床应用：人工耳蜗评估

• 批准号: 9249153
• 负责人: Rene H Gifford
• 金额: $ 12.36万
• 依托单位: VANDERBILT UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-08-13 至 2018-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9249153
• 关键词: Clinical; Application; Spectral; Envelope; Perception

9. PROJECT SUMMARY/ABSTRACT Most modern day cochlear implant (CI) candidates have residual acoustic hearing in one or both ears. Several studies have shown that this residual hearing provides significant benefit when paired with a CI in a bimodal listening configuration. The degree of acoustic-related, bimodal benefit however, varies across ears and is not correlated with audiometric threshold, etiology, age or preoperative speech recognition. In the absence of gross differences in preoperative hearing acuity, patients presenting with residual hearing in both ears are commonly told that either ear could provide benefit when paired with a CI. There is no clinical measure that provides predictive utility for selecting the ear to be implanted-a critical consideration particularly in cases for which bilateral cochlear implantation may be restricted (i.e. insurance restrictions such as encountered with Medicare and Medicaid). This application proposes to develop and implement such a clinical tool. The clinical test of spectral modulation detection (SMD) is a modified version of a validated psychophysical procedure assessing spectral resolution. In this task, the listener is asked to discriminate spectrally-flat noise from spectrally-modulated noise. Pilot work on this clinical procedure has shown SMD in the non-implanted ear is an excellent predictor of acoustic benefit (r = 0.89) when paired with a CI for bimodal hearing. Because this task contrasts noise stimuli, it does not require speech understanding and can be completed by candidates with very little residual hearing-both of which are expected for individuals being evaluated preoperatively. Pilot work with our most recent iteration of the clinical task takes 5 to 6 minutes per ear, is highly correlated with acoustic benefit in quiet and noise, and is reported as a percent correct score. This tool has the potential to satisfy a strong need in the fields of audiology and otology as well as significantly influence surgical decisions and patient outcomes. At the conclusion of this study, we will provide clinicians with a pre- and post-implant test of auditory integrity, the supporting tools to translate test scores to meaningful predictions about the potential benefit of each ear in specific treatment conditions, and a data-driven guide to ear selection. Thus, the study has the potential to help us meet the evidence-based objective in medicine in the areas of implant ear selection, expectations management, and modality selection (bimodal hearing or bilateral implantation).

9。项目摘要/摘要 大多数现代人工耳蜗植入物（CI）候选人在一个或两者中都有剩余的声学听力 耳朵。几项研究表明，与CI配对时，这种残留听力可为 在双峰聆听配置中。然而，与声学相关的双峰益处的程度各不相同 耳朵，与听力学阈值，病因，年龄或术前语音识别无关。在 术前听力敏锐度缺乏严重差异 通常告诉耳朵，两次与CI配对时，任何耳朵都可以提供好处。没有临床 提供预测效用的度量，以选择为植入的耳朵 - 关键考虑 特别是在双边人工耳蜗可能受到限制的情况下（即保险限制 正如Medicare和Medicaid所遇到的那样）。本申请建议开发和实施这样的 临床工具。光谱调制检测（SMD）的临床测试是经过验证的修改版本 心理物理程序评估光谱分辨率。在此任务中，要求听众歧视 来自光谱调节噪声的光谱噪声。该临床程序的试点工作已显示SMD 当与CI配对时，非植入的耳朵是声学益处的出色预测指标（r = 0.89） 听力。因为此任务与噪声刺激对比，所以它不需要语音理解，可以是 由候选人完成的，很少有残留的听力为个人 术前评估。试点我们最近的临床任务迭代需要5至6分钟 耳朵与安静和噪音中的声学益处高度相关，据报道是正确的分数。 该工具有可能满足听力学和耳鼻喉科领域的强大需求 影响手术决策和患者预后。在这项研究的结尾，我们将为临床医生提供 通过对听觉完整性的植入前和植入后测试，将测试分数转化为有意义的支持工具 关于每只耳朵在特定治疗条件下的潜在益处的预测，以及数据驱动的指南 耳朵选择。因此，该研究有可能帮助我们实现医学中的基于证据的目标 植入耳朵选择，期望管理和方式选择区域（双峰听力或双边 植入）。